https://www.um.edu.mt/library/oar/handle/123456789/91979 2026-04-04T21:20:28Z https://www.um.edu.mt/library/oar/handle/123456789/99157 Title: Real-time tracking of patients’ experience in an acute rehabilitative hospital setting in the delivery of person-centred care Abstract: Purpose: This study explored how real-time tracking of patients’ experiences in a rehabilitation hospital can be used by healthcare professionals to improve the delivery of Person-Centred Care to patients. Design: A qualitative research methodology was adopted, whereby the phenomenological qualitative tradition was applied with an interpretivist epistemological approach, to conduct a case study of how Real-Time Experience Tracking can be used to improve the delivery of Person-Centred Care in the chosen hospital. Real-time data on patients’ experiences was collected and subsequently used to stimulate discussions during several interviews that were held with various healthcare non-managerial and managerial professionals at the rehabilitation hospital. Findings: Several themes emerged on each of the three pillars of Person-Centred Care and on the use and acceptance of Real-Time Experience Tracking by patients and healthcare professionals. The relatively innovative method of collecting data on patients’ experiences in real-time was generally accepted by both patients and healthcare professionals. Additionally, Real-Time Experience Tracking can be used to improve the delivery of Person-centred Care by promptly highlighting weaknesses on each of the three pillars of Person-centred Care, for the consideration of healthcare professionals. Conclusion: Collecting real-time data on patients’ experiences can improve healthcare professionals’ understanding of patients’ experiences and thus enable them to adjust their treatment plans and delivery in time to improve patients’ experiences. Questions on which real-time data are collected need to be carefully aligned with the three pillars of Person-centred Care. Real-time data can also enable the hospital to measure the quality of Person-centred Care and continuously improve the care provided to the current needs of its patients, rather than sticking with standard procedures. Practical limitations to improving Person-centred Care with Real-Time Experience Tracking include preserving patient anonymity and lack of time and resources. Healthcare institutions should evaluate how the recommendations being made in this study can enable them to track their patients’ experiences in real-time to improve the delivery of Person-Centred Care for the same patients. Value: Several recommendations on how Real-Time Experience Tracking can be implemented to improve the delivery of Person-Centred Care were proposed. These recommendations were based on findings from interviews held with various healthcare professionals working at the rehabilitation hospital. Healthcare institutions should consider developing an application to collect data in real-time on patients’ experiences and analyse it to assist healthcare professionals to improve the delivery of Person-Centred Care. Description: M.Sc.(Melit.) 2021-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/92490 Title: To assess the attitudes of nurses and consultants on the implementation of advance directives in the Maltese health system Abstract: Background: An Advance Directive is a legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. Knowledge of and the attitude towards Advance Directives, can contribute to nurses' and physicians’ confidence in discussing EOL issues with patients and families. In Malta, the option of Advance Directives is still not available. The implementation and effect of Advance Directives in a health system still needs to be investigated. Aim: The aim of this study is to investigate nurses’ and consultants’ attitudes toward the implementation of advance directives for patients in an acute care setting. Method: Several databases were used to search for relevant studies for the literature review related to the chosen topic. For the local research investigation, a descriptive, exploratory nonexperimental design has been considered to be the most suited type of research design for this study. A mixed methods design using both quantitative and qualitative research were used to conduct this study. For the Quantitative research, a questionnaire was provided to 348 nurses working in Medical Wards at Mater Dei Hospital and in Sir Anthony Mamo Oncology Hospital. A total of 214 questionnaires were collected. For the Qualitative aspect of this study, a semi structured audio-taped interview, was done with 6 Consultants, 5 individuals in a managerial position and 1 key expert. The data was conducted in the same period hence this will result in cross-sectional research study design. Results: Nurses and Consultants tend to have a general positive attitude toward the implementation of Advance Directives in the Maltese Health System. From a managerial perspective, ethics and legal issues were identified as being the two main challenges for the implementation of Advance Directives. Barriers in communication and the Maltese culture and religion may also hinder the implementation of Advance Directive in the Maltese Health System. Conclusion: It is recommended that education and training about Advance Directives is given to all healthcare professionals and to the general public. The creation of proper guidelines, protocols and policies could also help all parties involved so as to handle any challenges and dilemmas related to the implementation and practice of advance directives. More in-depth studies need to be carried out in order to strengthen the evidence and explore any emerging issues on Advance Directives. Description: M.Sc.(Melit.) 2021-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/92426 Title: Authentic leadership, psychological safety and whistleblowing : a mixed method approach Abstract: The World Health organisation (2018) stresses the importance of a reporting environment within the healthcare sector to identify causes of errors, near misses or adverse events without fear of reprisal, having a non-punitive and blame free environment. Research has shown that authentic leadership and psychological safety play a critical role in speaking up behaviour as members of staff assess the behaviour of key leadership figures before deciding what action to take. The term whistleblowing is used synonymously with ‘raising of concerns’ or ‘speaking up’ as a definition to whistleblowing (Jones & Kelly, 2014). This research study tests whether there is a relationship between authentic leadership, psychological safety and speaking up. The research study takes a cross-sectional mixed method triangulation design. It assumes a positivist research paradigm supplemented by sequentially performing an exploratory qualitative study to give a more pragmatic research paradigm. Although the qualitative section is by no means complete, it has given a deeper perspective of what the results of the mediation model represents. The target population include the Paediatrics, Obstetrics and Gynaecology, Medicine, Cardiology and Orthopaedics departments. In total 666 invitation letters were distributed achieving a response rate of 26.6%. The research tool from the study was adapted from ‘The Speaking Up About Patient Safety’ version (Appendix A), from Schwappach et al, (2018). The findings from the study support the theoretical framework addressing the relationship between psychological safety, authentic leadership and speaking up. The study found that psychological safety does mediate the relationship between authentic leadership and speaking up; and the influence of authentic leadership and speaking up intentions are partially mediated by psychological safety. The type of response and engagement by management and supervisors may have a positive influence on attitudes towards reporting wrongdoing (Hsuan Lee et al, 2016) by creating an environment of psychological safety. Description: M.Sc.(Melit.) 2021-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/92425 Title: What contributes to burnout and the state of well-being among speech language pathologists working in the public sector? Abstract: Speech Language Pathologists (SLPS) are Allied Health Professionals (AHPs) who provide an assessment and intervention service in relation to speech, language, and swallowing difficulties, within settings such as hospitals, community clinics and mainstream schools. Assessment and therapy is provided to people of all ages, and usually involves provision of ample sessions. Such frequent contact made with service users may increase the likelihood of the therapist feeling stressed and developing burnout. Burnout consists of emotional exhaustion, depersonalisation, and a lack of personal accomplishment. The public entity is comprised of 100 SLPs and in the last two years 11% of the employees resigned which led the researcher to investigate burnout. The aim of this research is to determine the burnout level among SLPs working in the public sector. Together with the participants, the researcher sought to identify possible links to burnout and strategies to overcome it. The suggestions will be put forward to management for consideration, in the hope of improving the employees’ work engagement. The study employed a mixed cross-sectional research design. The quantitative design included a survey which collected demographics data and responses to the Maslach Burnout Inventory – Human Services Survey. The sample included the total population of SLPs working within the public sector of 100 persons, with a response rate of 82% (n = 82). The qualitative design employed a focus group discussion with 12 participants (15%). Results suggested that 32 SLPs (39%) claim to experience a high level of burnout, 27 (32%) average levels of burnout and 24 SLPs (28%) claim to experience a low level of burnout. Findings reported age (p =0.028), education level (p = 0.035) and workplace setting (p = 0.022) as the demographic variables linked to burnout. Emotional exhaustion has the strongest significant correlation with depersonalisation (r = -0.56, p = 0.05). and these are both significantly negatively correlated to personal accomplishment r = -0.22, p = 0.05 and r = -0.40, p = 0.05 respectively, meaning that the SLPs feeling depersonalised are very likely to feel emotionally exhausted and lack personal accomplishment. Issues with work-life balance, COVID-19 pandemic, limited resources, the nature of the work, excessive paperwork, isolation, and lack of recognition were all noted to be drivers for burnout. Strategies used to overcome burnout included embracing a positive outlook, appropriate communication and support, and the standardisation of workplaces. This study depicts the levels of burnout which SLPs experience, drivers for burnout and strategies to reduce burnout. Recommendations for management included the reduction of administration duties, setting up of appropriate channels for support within the workplace, promote awareness of the profession, and the introduction of stress management continuous professional development opportunities. The study provides suggestions on changes that can be done within the community of SLPs working within the public sector. Description: M.Sc.(Melit.) 2021-01-01T00:00:00Z